Poll - Spring 2011

Are you in favor of state licensing boards requiring pre-licensed therapists to undergo psychotherapy as part of licensure requirements, assuming all potential issues are addressed and adequately resolved prior to implementing such a requirement?

 

Yes 69.25% No 23.87% Maybe 6.87% Total vote count: 6765 Mental Health Professionals Yes 69.61% No 22.92% Maybe 7.47% GoodTherapy.org Members Yes 79.88% No 14.79% Maybe 5.33%

Chart.

 

Comments

• therapists who don't do therapy, bad bad bad Reply

  • Yeah, its like brain surgeons who don't have brain surgery, bad, bad, bad or perhaps good, good, good
  • You can't compare psychotherapy to brain surgery... A brain surgeon does not need to undergo brain surgery in order to become a skilled surgeon. However, there are two main reasons I think a therapist should undergo his or her own therapy: 1) it is one of the best ways to learn how to be an effective therapist and 2) EVERYONE has unconscious blind spots and issues which will impact, limit, and, sometimes, cause harm to a client when not addressed or made conscious. Therapy is not only for dealing with 'medical model' disorders, it also helps a person to recognize more subtle personality issues and is used for personal growth and self-actualization.. I am frightened by the number of practitioners who have commented on this blog/poll who hold the belief that therapy is only for treating mental illness. I agree that there are many problems with mandating therapy for pre-licensed therapists and that perhaps this should not be regulated on the state level. But, if you don't understand the value of therapists undergoing their own therapy, how such an experience improves the efficacy of therapy, then you should seriously consider going to your own therapy and finding out... Don't knock it until you try it!
  • Yes, It should be prohibited
  • Let's make a better comparison then. Do we require physical therapist to have physical therapy before they can treat patients? Nope. How about an even more relavent one. Do we require Psychiatrists to see a Psychiatrist prior to seeing patients. Nope. Why should counseling/therapy be different?
  • SO MAYBE WE SHOULD HAVE PHYSICAL THERAPISTS AND BRAIN SURGEONS HAVE TO UNDERGO PSYCHOTHERAPY BEFORE THEY ARE LICENSED...AND TEACHERS AND POLICEMEN AND POSTAL WORKERS. MAYBE MUSICIANS AND ARTISTS ARE OK WITHOUT IT.
  • Not to speak of the fact that many licenses that involve therapy are for people who will not do therapy - particularly not in the form that seems suggested by many commentators on this webpage. In most states, for example, a psychologist license is general. Someone may become an industrial psychologist, but would with the suggestion have to go through therapy to become licensed. Many therapists also engage in forms of therapy where their own baggage, unless profound, is unlikely to affect their work to a significant degree.
  • Yes, I agree, In my opinion is very important that as a therapist we take care our on need first.

• In over 40 years of practice I have had to pick up the pieces of too many clients who were messed up by therapists' issues/problems. Reply

  • I think many of us have had this experience. Too easy for therapists to have countertransference, unresolved issues be awakened in the care of another seeing treatment. We all should encourage each other in the business to examine their processes in the room with clients/patients.
  • It is frequent that I am in the same position. There is no quality control, no evaluation of practice unless there is a gross action THAT IS REPORTED BY THE CLIENT. The majority of negligent, uninformed and potentially damaging actions do not get reported and may result in the client believing that all therapists behave that way. Falling asleep in sessions, stating that ones style is sarcastic, asking a client that had been kidnapped and stabbed how was your week never assessing for or providing information on PTSD, avoiding discussing rape or sexual abuse or blaming the client, playing in the pool with a client without any goals or progress, inappropriate touching of clients and many, many more actions occur- this list only is of the last several months. There is more training, oversight and quality control in most other positions, including non-professional. We work with people who are vulnerable, with the heads, hearts and souls in isolation, just us and them. Don't we have a responsibilty to avoid harming the client? If not us, who If a client has been abused by a parent or other, and we injure them by negligence, lack of skill or other factor aren't we a part of the problem?
  • For me it has been over twenty years and I've had similar issues as well as a personal one.
  • A former patient called me seriouly suicidal (plan, time frame, means) and told me her current therapist won't return her calls and cancelled two appointments because the therapist's mother had committed suicide and my client's threat triggered her own PTSD. It is certainly understandable that she has this problem, but she shouldn't specialize in working with PTSD and borderline PD, both of whom are often suicidal. In fact, one of the patients in her therapy support group already committed suicide a few months ago. Having this problem and continuing to work with this population seriously jeopardizes the safety of her clients. She does good work when they are not suicidal, but this should have been assessed prior to licensing her so that there could be a provision that protects clients at risk.
  • No one can teach 'experince" by knowing who we are on all levels, intrapsychically, interpsychically, in our external life assistis in gaining the insight necessary to treat other persons. This means knowing our capacities and limitations. This means knowing and connecting to who we genuinly are. This takes committment and dedication. Patients can only go as far as there therapists are able. It is impossible to conduct a treatment that will have a successful prognosis without a full training. Treatment is a part of training. Patients need to know if they are getting supportive therapy, insight oriented therapy, psychoanalysis. Dealing with negative transerance is par for the course and it is this aspect of treatment that if dealt with skill our patients can expereince a corrective emotional experience through genuine connections and interventions. Otherwise, the treatment is simly a 'wild' journey that is not scientifically based. I also believe, that if the therapist is not interested in psychodynamic treatment and wants to do counseling instead, then they still need to understand what differentiates counseling, from psychotherapy, or analytic psychotherapy from analysis. Either way, clinicians can gain from the experience. This, we owe to our patients. Thus enabling the practice, 'First, do no harm". Healing and getting well do not run on the same prallel.
  • Some of the worst experiences I have had in my personal therapy have been with institute-trained psychoanalysts, who are required to participate in psychoanalysis themselves as part of their training. Participating in personal therapy or a "training analysis" does not necessarily mean that the participant becomes a better therapist.This may or may not be more true when the participation has been mandated by those who have authority to evaluate, and pass or fail, the participant.I also don't know if therapists who have not participated in therapy are worse therapists overall because of not having had the experience. These questions are researchable, and I hope that they are researched well before anyone starts a movement to coerce therapists-in-training into personal therapy. Students might be better persuaded by empirically supported arguments about how personal therapy improves specific outcomes for clients.
  • Well said. Couldn't agree more about dangerous therapists.
  • and how many of those bad therapist had indeed their own therapy????

• This is why therapists should practice self care for themselves and seek therapy if they find a possible impairment. As we speak with individuals, families, etc., sometimes certain items we never knew were a problem will occur. If one had to try to find and fix all problems before becoming a therapist, they still would not until faced with the problem - plus they would not really know it is "fixed" until faced with the situation or one like it during session. Reply

  • I believe the all problems addressed" statement refers to potential issues as far as creating and implementing this as a law. Certainly it would be absurd to require therapist to work through ALL of their issues... there is no such thing as having done that. That being said, some therapist practice without themselves having EVER been in therapy. This is a serious problem and should not be tolerated by any board, institution, school, state, etc...
  • I believe experiencing the therapeutic process first hand should be standard part of the educational and training process while in Graduate School. This way there should be no negative impact on the availability or total number of therapists ready to serve the public at any given time. I do not interpret the spirit or letter of this requirement to be for therapists to become "perfect" and totally healed of all their wounds before they can practice. That is an unreachable goal. I do think that being a therapist without having any idea what it is like "to sit in the other chair" while encouraging ~even expecting~ our clients to look at their issues or problems and to commit to changing themselves, their lives, and their relationships, is essentially a hypocritical double-standard, unwise and unethical.
  • It is unethical to leave it to our patients to find out our own problems. The issues of transference and countertransference are critical. One needs to understand a predisposition to a bias or anger well BEFORE "discovering" it in a therapy session.
  • This is a reply to all "no" responses. First, no one ever said ALL (or even ANY) of the potential therapists' issues would have to be resolved before they could become therapists -- only that they should go through therapy. The difference between a surgeon going through surgery and a potential therapist going through therapy is that not everyone neesa surgery. If we are honest with ourselves, we ALL have some kind of issue. The people who think they don't have any issues are usually driving everyone around them crazy because they are "never wrong." Furthermore, some medical schools DO require physicians to be bedridden patients in hospitals. Those who have undergone this experience are more likely to maintain an awareness of patients humanity. As a therapist, I require that my clients work at making their lives better by implementing the skills I teach them, doing "homework," reading, etc. If I hadn't been through this humbling process myself, I might be like some of my peers who tend to be bossy, arrogant, and judgmental about their client's struggles. The best professors, the best counselor peers, and the best counselors I have had ALL went through therapy themselves throughout their lives. Confidentiality would have to be guaranteed so that potential therapists' issues would not be revealed.
  • What about practicing what we preach? Entering therapy when something comes up is an ethical responsibility in addition to a moral one. We are our tools. We don't have to fix all before we treat, but need to be a work IN PROGRESS. If we don't we miss key issues that need to be addressed consciously or subconsciously (e.g. being anxious about sexual abuse or suicide leading to avoidance of the topic) that lead to, a number of times inadequate treatment. This has occurred FREQUENTLY in Rockland County, NY and I'm sure elsewhere. We need to know what we don't know and what may be acted out on without our knowledge. I know that I, like any human, cannot be in myself and seeing truly from another perspective at the same time. I may have a strong observing ego but I WILL miss some things, I'm human. Sometimes what we don't see, recognize or know can have a profound effect on what we do, and what happens to our client
  • As a therapist I really try to avoid seeing the client as "broken" and in need of "fixing". Psychotherapy for the therapist would not be about being a perfect unflawed human being.
  • Without knowing our own issues, we will certainly splash them all over our clients. And it isn't IF there are problems. EVERYONE has some kind of characterological issue that is most likely unconscious to the holder. Saying that we don't have this only proves we are blind to our own problems.
  • yes

• It is essential that all psychotherapists understand their own struggles and demons so they do not interfer with their practice and hurt clients. Reply

  • I agree!
  • The more we break through our own obstacles to love, purpose and fulfillment the better we can help our clients.
  • I believe experiencing the therapeutic process needs to be standard part of the educational and training process while in Graduate School and beyond. Knowing yourself is integral to helping others know themselves.
  • agree.

• I did therapy and chose my therapist. It was a cornerstone of my strength as a therapist. Reply

  • I couldn't agree more!
  • Absolutely! Plus, what a great way to understand the vulnerability that clients bring when they come into our offices. It takes courage to bare your soul to a stranger when you come in for that first visit.

• I believe this idea is absurd and would delay services to already underserved populations. Reply

  • I find this response absurd.
  • I agree that it would be a time waster. The intern's supervisor has the responsibility to determine if the intern is unfit for the profession; that is partly the point of the internship.
  • I totally agree.
  • So would you think it absurd for a doctor to not practice healthy practices?
  • By all means let's delay services provided by therapists who have not done their own work in therapy.
  • I'm tired of picking up the pieces for clients whose previous therapists were not self aware. It is not a supervisor's job to be the supervisee's therapist.
  • intern supervisors do not usually prevent students from becoming msw's. typically the intern supervisors are interested in helping to move the student along, not hold them back. Social work programs are very generous and accommodating. I'm refuting the statement above which says that intern supervisors should decide if students are ready to provide therapy. Going through therapeutic process is an excellent way to learn to provide therapy and should be required of students/interns/etc.
  • WHAT??????
  • Therapists who don't do their own work end up working their issues out through their clients. This is a huge disservice to the client.
  • How can anyone who calls themselves a "therapist" call the idea of therapy absurd? That shows a level ofarrogance that should definately not have access to the underserved and struggling in our society - better they go unserves than badly served. I do not think therapy should be mandated but rather highly recommended. Academics could not be given this burden as they are bound to teach not treat and that would muddy the waters.

• Although I believe all therapists should do their work on a continuing basis - I do not believe it should be required because then it would just be a "check the box" issue - not really therapy. Those that want to do their work to be a good therapist, will do it voluntarily. Reply

  • Well said.
  • I, too, think that's well said! Being forced into therapy is already creating an issue in and of itself. A great deal of therapists who become therapists have likely already had previous therapy in their lifetime. A voluntary experience is definitely healthier.
  • I voted "yes" on this survey, but I also agree with this statement. I signed up for therapy voluntarily because a mentor told me that it's the only way to become an effective therapist. It was very beneficial for me, and I am still in favor of requiring it.
  • While it would be an issue that therapy might become simply "check the box," at the same time, I don't think anybody doing therapy should be unfamiliar with what it feels like to be on the other side of the room.
  • I agree. How many clients that you have seen do well under mandated conditions?
  • Amen. It would be just one more requirement and would likely have little bearing on the "issues" presented in the "yes" answers. Just because a therapist goes through some required number of therapy sessions to become licensed doesn't mean they would not create problems for clients and practice ineffective therapy anyway.
  • A therapist who hasn't done their own therapy -- to me that's just a very peculiar idea. The analog isn't the surgeon, but the artist: Can you imagine a painter who had literally never seen other folks' paintings? Or an actor who had never seen a movie/TV show/play? A musician who had never heard any music? While not strictly necessary to do the work, I can't help but believe that such a person would be missing some serious background that would be really helpful. I would never refer to anyone who hadn't done their own work. Never. On the other hand, I think we need to make a distinction between something being advisable vs required. People who are avoiding their own work will still get licensed, can still show they've done their X hours of "therapy." So I don't think it would solve much. No, don't require it, just meet with your peers and get to know them, and only refer to people who do their own work.
  • well said!
  • I agree with this. And if it's required, those who did it only because of the requirement will have one more check box lulling the public into the false belief that licensed therapists are across-the-board trustworthy.

• Some graduating programs already require this. Perhapes state licensing boards need to make this a requirment for graduate schools, before the canadent seeks licensing. Reply

  • i agree that graduate school is the ideal time for this requirement, It is a time when the individual is already learning how to think in new ways and personal therapy is an excellent place to practice and cement these skills as well as monitor progress and suitability in the profession
  • It is the ideal time to require personal therapy. Mine did, and I am so glad for it. Graduate school should be a time of intellectual and personal growth. It should also a winnowing process for the candidates who will eventually seek licensure. It is much better to require adequate didactic therapy during the early years of preparation than to require later discipline that may cost the professional his or her license -- especially after the young professional has invested so much time and treasure in the process.

• Way to Go GoodTherapy.org! Important topic. Reply

  • I hope you dont stop with this poll .fIND A WAY TO BRING IT TO A WIDER AUDIENCE.

• Every professional should experience therapy at least once. But mandating it- absolutely not. A client comes to therapy out of a desire to change. Those who are mandated are their generally to "do their time" It is a waste of time for them and the provider. Why don't we focus on encouraging those in need to seek treatment rather than creating regulations. Stop with the Progressive Agenda. Reply

  • Wow! Sounds like maybe you should address your anger / paranoia issues with a therapist.
  • Well, as someone with a Progressive Agenda, I actually agree with your take on it. So, stick THAT in your pipe and smoke it! :-)
  • Progressive? I'd say that not requiring therapy for someone who holds such power over another's emotional well-being is regressive. It's the relationship, stupid. Implication in therapy is that there needs to be at least one mentally healthy person present. Hopefully that's the therapist.
  • There is nothing progressive about that agenda.
  • To effectively help a client it is beneficial to be a client first! After all a therapist can only take a client as far as they have gone themselves. Furthermore, this promotes therapist self awareness and reduces risk of burnout and VT.